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The objective of this study is to evaluate the clinicopathological features and immunohistochemical characteristics of epithelioid trophoblastic tumor (ETT). Seven cases of epithelioid trophoblastic tumor treated in the Women's Hospital of Zhejiang University from 2004 September to 2008 December were retrospectively analyzed. Immunohistochemical study was performed. The most common presenting symptom was vaginal bleeding. Four patients had prior evidence of molar pregnancy and three patients presented with metastases. Mean age at diagnosis was 34.7 years. Mean pregnancy interval was 3.39 years. Human chorionic gonadotropin levels were 33.25-174315.5 IU/l. One case died from metastasis in lungs. The remaining six patients survived without recurrence. Immunohistochemistry revealed diffusely positive for CK18, and focally positive for β-hCG, HPL, Mel-CAM (CD146) and inhibin-alpha. Nuclear staining of Ki67 and p63 were seen. The confirmation of epithelioid trophoblastic tumor diagnosis is difficult before surgery. Surgical intervention is the recommended primary treatment.

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PurposeNotch signaling was recently found to be associated with prognosis of some cancers. The aim of the study is to investigate significance of the expression of HES1/HES5 protein, downstream effectors of Notch, in prognosis of the patients with advanced ovarian epithelial cancers.MethodsFormalin-fixed, paraffin embedded tissues and clinic-pathological parameters from 61 patients with FIGO stage IIIc–IV ovarian serous adenocarcinoma were collected, the expression of HES1 and HES5 protein were immunohistochemically detected, and the association of HES1 and HES5 expression with survival of the patients were analyzed.ResultsThe expressions of both HES1 and HES5 in adenocarcinoma were significantly higher than those in adenoma and normal control (χ2 = 32.915, P = 0.000 and χ2 = 46.863, P = 0.000 respectively). Overall survival and disease-free period were longer in HES1 low-expression patients (median 43.0 and 22.0 months) than those in high-expression patients (median 24.0 and 14.5 months). Of those, Overall survival period of patients with HES1 low-expression was significantly longer than that of those with high-expression (χ2 = 4.049, P = 0.044). Univariate analysis and multivariate Cox regression model did not show that HES1 or HES5 expression was a factor associated with survival of advanced ovarian serous adenocarcinoma patients.ConclusionsThe expressions of bHLH gene HES1 and HES5 are increased in advanced ovarian serous adenocarcinomas, and HES1 high-expression probably is a potential poor prognostic factor for the patients.

The incidence of coexisting ovarian cancer in clinical stage I endometrial carcinoma is low, but the decision for ovary preservation at the time of operation still needs to be made with caution because of occult ovarian metastasis, especially for patients with high-risk factors.